Sneak Peak Into: Soccer Injury Prevention and Treatment. Part 7

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soccer player lying on field holding injured leg

Sneak Peak into Soccer Injury Prevention and Treatment: A Guide to Optimal Performance for Players, Parents, and Coaches.

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Available May 28th, 2014

This week take a look at a topic discussed in John Gallucci Jr.’s book:

ACL Injuries in Soccer: Recovering After Surgery

It is the general consensus that anyone competing in athletics or who will continue to be physically active throughout their lives needs to have surgery following an ACL injury. Usually, the athlete will be back in rehab with a physical therapist within one to 10 days of their surgery.

Although it may seem like a long road ahead for the athlete, the process can be broken down into stages so as not to overwhelm the athlete with timelines. In the early stages, I tell my athletes to look at their rehab as three separate, eight-week intervals. Keep in mind that although treatment plans will be similar, each orthopedic surgeon has their own post-surgical protocol. This often depends on the individual athlete and what exactly was repaired or corrected during surgery.

Recovery Plan for ACL Surgery

Phase I (Weeks 1 to 8): The most important thing during this stage of ACL recovery is to protect the new graft! The new graft must heal into the bone, and has to be given a chance to scar down into place to restore stability in the knee. Over the course of the first eight weeks, the following should be achieved:

  • Decreased pain and inflammation
  • Increased range of motion from 0-90 degrees
  • Good quad muscle contractions
  • Managed scarring and incisions
  • Progression to full weight-bearing
  • Normal gait pattern

Phase II (Weeks 9 to 16): At this point, the graft has had a good chance to heal into the bone. During this eight-week period, the objective is to return joint integrity and strength, using a variety of exercises. The following should be addressed:

  • Increasing strength of hip, foot and ankle
  • Leg press exercises
  • Functional squats
  • Leg curls and leg extensions

Phase III (Weeks 17 to full return to play): Every athlete enjoys this part of rehab. This is when they begin to see the light at the end of the tunnel and can begin to return to a higher level of activity. This period should include the following:

  • Running
  • Directional running
  • Lateral motions
  • Diagonal motions
  • Balance and proprioceptive (awareness of body parts and movement) exercises
  • Low-level plyometrics – also known as “jump training,” where athletes exert a large amount of force in quick intervals to increase speed and strength; for example, by repeatedly jumping from the ground onto a raised platform

During these last eight weeks of ACL recovery, the athlete can also begin sport-specific activity. With the physician’s permission, the athlete can begin a training plan that will get them back on the pitch, but he or she must realize they have not played a soccer game in six months and the return to play must be done gradually; no one wants to ruin six to 12 months of rehab by rushing back onto the field.